Design of vessel ligation simulator for deliberate practice

Hsu, Justin L.; Korndorffer, James R.; Brown, Kimberly M.

doi:10.1016/j.jss.2015.02.068

Cited by 14 publications

(6 citation statements)

References 16 publications

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“…Since it is difficult to access surgeons in specialized fields to volunteer for such initiatives, this number of participants is usually considered as acceptable. The majority of the earlier studies were also conducted with limited number of participants, such as 14 surgeons (Wilson et al, 2010), 22 surgeons (Cope et al, 2015), 9 neurosurgeons (Eivazi et al, 2017), 12 students (Uemura et al, 2016), and 19 surgical residents (Hsu et al, 2015). Of the 23 participants in the current study, 14 (three females) were novices with an average age of 27.71 (SD = 6.96), with no one having previously performed an endoscopic surgery on their own.…”

Section: Participantsmentioning

confidence: 99%

“…Thus, these virtual and interactive settings in computer-based systems are risk-free ( Gallagher and Satava, 2002 ; Maran and Glavin, 2003 ; Earle, 2006 ; Van Sickle et al, 2006 ; Loukas et al, 2011 ; Seagull, 2012 ). Accordingly, several training scenarios have been developed for surgical-skill improvement and assessment requirements for surgery purposes ( McNatt and Smith, 2001 ; Gallagher and Satava, 2002 ; MacDonald et al, 2003 ; Jones, 2007 ; Curtis et al, 2012 ; Feldman et al, 2012 ; Hsu et al, 2015 ). Oropesa et al (2011) report that adaptation of newly developed tools and techniques to surgical training programs has the possibility to realize an essential role for the assessment of surgical skills.…”

Section: Introductionmentioning

confidence: 99%

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Distinguishing Intermediate and Novice Surgeons by Eye Movements

Dalveren

Çağıltay

2020

Front. Psychol.

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Surgical skill-level assessment is key to collecting the required feedback and adapting the educational programs accordingly. Currently, these assessments for the minimal invasive surgery programs are primarily based on subjective methods, and there is no consensus on skill level classifications. One of the most detailed of these classifications categorize skill levels as beginner, novice, intermediate, sub-expert, and expert. To properly integrate skill assessment into minimal invasive surgical education programs and provide skill-based training alternatives, it is necessary to classify the skill levels in as detailed a way as possible and identify the differences between all skill levels in an objective manner. Yet, despite the existence of very encouraging results in the literature, most of the studies have been conducted to better understand the differences between novice and expert surgical skill levels leaving out the other crucial skill levels between them. Additionally, there are very limited studies by considering the eyemovement behaviors of surgical residents. To this end, the present study attempted to distinguish novice-and intermediate-level surgical residents based on their eye movements. The eye-movement data was recorded from 23 volunteer surgical residents while they were performing four computer-based simulated surgical tasks under different hand conditions. The data was analyzed using logistic regression to estimate the skill levels of both groups. The best results of the estimation revealing a 91.3% recognition rate of predicting novice and intermediate surgical residents on one scenario were selected from four under the dominant hand condition. These results show that the eye-movements can be potentially used to identify surgeons with intermediate and novice skills. However, the results also indicate that the order in which the scenarios are provided, and the design of the scenario, the tasks, and their appropriateness with the skill levels of the participants are all critical factors to be considered in improving the estimation ratio, and hence require thorough assessment for future research.

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Section: Participantsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Distinguishing Intermediate and Novice Surgeons by Eye Movements

Dalveren

Çağıltay

2020

Front. Psychol.

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“…They suggested that this force indicates the competency of surgical knot-tying and published several reports about comparisons of the force between medical students and groups of attendings (emergency physicians, surgeons, and gynecologists [13][14][15]). Recently, researchers have tried to de ne "tying gently" by measuring the force applied during open knot-tying [16][17][18][19][20][21]. To assess the force, researchers mounted a deformation sensor on a homemade vessel ligation simulator to continuously record the deformation of the mock vessel during knot-tying [16][17][18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

“…Recently, researchers have tried to de ne "tying gently" by measuring the force applied during open knot-tying [16][17][18][19][20][21]. To assess the force, researchers mounted a deformation sensor on a homemade vessel ligation simulator to continuously record the deformation of the mock vessel during knot-tying [16][17][18][19][20][21]. Actually, vessel ligation is an ideal format for developing objective metric measures in simulation training of surgical knot-tying techniques.…”

Section: Introductionmentioning

confidence: 99%

“…Actually, vessel ligation is an ideal format for developing objective metric measures in simulation training of surgical knot-tying techniques. At least three direct objective metric models have been developed based on it and reported [17,19,21]. However, these developers focused on measuring force exertion rather than knot security (tightness).…”

Section: Introductionmentioning

confidence: 99%

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Developing and Evaluating a Novel Vessel Ligation Simulator Designed for Teaching Surgical Knot-Tying: A Mixed-Methods Study

Wu,

Yau,

Lin

et al. 2024

Preprint

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Background: Surgical knot-tying is a fundamental learning subject for surgical novices. However, no existing knot-tying training simulator offers a direct objective measurement of knot security, a critical feature of professional performance in this skill. This study aims to bridge this gap by developing a novel knot-tying simulator capable of assessing knot security objectively. Its educational impact was also investigated through professional user evaluation.Methods: A three-phase mixed-methods research study was conducted from August 2021 to September 2022. The first phase involved developing and manufacturing a novel vessel ligation simulator that measured the pressure-holding ability of knots, serving as an indicator of knot security, through post-ligation pressure testing. The second phase involved the participation of expert surgeons (n = 6) and Year-5 medical students (n = 30) in product evaluation. The final phase was a mixed-methods data analysis to determine the educational impact of the simulator. The collected data included participants’ demographics, prior experience in surgical knot-tying, performance metrics on the simulator, experts’ responses to a five-point Likert scale survey of simulator validity, novices’ responses to a 10-point scale survey of self-confidence in mastering surgical knot-tying skills before and after the training course, and their overall perceptions regarding the learning experience associated with the simulator.Results: The simulator was crafted using 3D-printing technology. The experts gave it high scores in face and content validity, with mean scores of 4.5 and 4.77, respectively. Twenty-four novice participants (80%) achieved knot security in vessel ligation by the end of the 3-hour training course, though they required more time for task completion compared to experts. Furthermore, all novice participants reported a marked increase in their post-class self-confidence in skill mastery. The unanimous approval from the novices highlighted the simulator's effectiveness in enhancing their learning, especially its high-fidelity design and objective feedback. This facilitated their reflection and motivation for the post-class deliberate practice.Conclusion: This study not only validates our hypothesis regarding the appropriateness of pressure-holding ability in teaching surgical knot-tying but also establishes a comprehensive methodological framework beneficial for curriculum developers to design effective simulation-based skill training in surgery.

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Simulation in Surgical Oncology and Hepato-Pancreato-Biliary Surgery

Brown

2019

Comprehensive Healthcare Simulation: Surgery and Surgical Subspecialties

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Design of vessel ligation simulator for deliberate practice

Cited by 14 publications

References 16 publications

Distinguishing Intermediate and Novice Surgeons by Eye Movements

Distinguishing Intermediate and Novice Surgeons by Eye Movements

Developing and Evaluating a Novel Vessel Ligation Simulator Designed for Teaching Surgical Knot-Tying: A Mixed-Methods Study

Simulation in Surgical Oncology and Hepato-Pancreato-Biliary Surgery

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